Gestational diabetes and central pontine myelinolysis with quadriplegia: A case report

被引:0
作者
Lee, I-Wen [2 ,3 ]
Su, Mei-Tsz [2 ,3 ]
Kuo, Pao-Lin [2 ,3 ]
Chang, Chia-Ming [1 ,3 ]
机构
[1] Natl Cheng Kung Univ Hosp, Dept Internal Med, Tainan 70403, Taiwan
[2] Natl Cheng Kung Univ Hosp, Dept Obstet & Gynecol, Tainan 70403, Taiwan
[3] Natl Cheng Kung Univ, Coll Med, Dept Med, Tainan 70101, Taiwan
关键词
Gestational diabetes; hyperglycemia; central pontine myelinolysis; hypernatremia; EXTRAPONTINE MYELINOLYSIS; HYPEREMESIS GRAVIDARUM; PREGNANCY; INSIPIDUS; RHABDOMYOLYSIS;
D O I
10.3109/14767050903156692
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Central pontine myelinolysis (CPM) has been reported in women with severe hyperemesis gravidarum-induced hyponatremia followed by rapid correction. Gestational diabetes with adipsia complicated by acute hypernatremia resulting in CPM has never been reported. Here is a case of a disabled female who presented with polydipsia, polyuria, seizures, fetal death in utero, hyperglycemia, and hyper-osmolar hypernatremia on her 31st gestational week. The dead fetus was delivered and the patient's plasma glucose and sodium were later stabilized. When the patient developed quadriplegia and respiratory failure 5 days later, brain magnetic resonance imaging showed central pontine and extra-pontine myelinolysis. Gestational diabetes complicated by hyper-osmolar crisis may cause fetal death and severe neurologic sequela. Early recognition and delivery of the fetus and placenta may improve the electrolyte and fluid imbalance.
引用
收藏
页码:728 / 731
页数:4
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